The Impact of Blood Pressure on Carotid Artery Stiffness and Wave Intensity in Patients with Resistant Hypertension after Renal Sympathetic DenervationDana Skultetyova1*, Slavomira Filipova1,2, Pavol Chnupa1, Juraj Madaric1, Viliam Fridrich3, Martin Gocar3 and Ivan Vulev4
- *Corresponding Author:
- Dana Skultetyova
Department of Cardiology and Angiology
National Institute of Cardiovascular Diseases
Pod Krasnou horkou 1, 83348 Bratislava, Slovakia
E-mail: [email protected]
Received Date: May 26, 2014; Accepted Date: July 05, 2014; Published Date: July 12, 2014
Citation: Skultetyova D, Filipova S, Chnupa P, Madaric J, Fridrich V, et al. (2014) The Impact of Blood Pressure on Carotid Artery Stiffness and Wave Intensity in Patients with Resistant Hypertension after Renal Sympathetic Denervation. J Hypertens 3:157. doi:10.4172/2167-1095.1000157
Copyright: © 2014 Skultetyova D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: The study investigated the impact of renal sympathetic denervation on office blood pressure and ambulatory blood pressure monitoring in patients with resistant hypertension. We evaluated whether a decrease in blood pressure may improve local carotid stiffness and parameters of wave intensity.
Methods: Renal sympathetic denervation was performed in 17 patients (age 55 ± 9 years) with true resistant hypertension. Measurements of carotid stiffness and wave intensity were performed using ultrasound combined with echo-tracking.
Results: We found significantly improved office systolic blood pressure changes 1 month (p=0.023) and together with pulse pressure changes at the 6 month follow up (p=0.041; p=0.016). Changes in systolic blood pressure during the daytime were significantly decreased at 1 month and diastolic blood pressure changes during the daytime were significantly reduced at 1 and 3 months. Stiffness parameters beta stiffness and pressure-strain elastic modulus were significantly reduced (p=0.04; p=0.03) and arterial compliance was increased (p=0.03), especially 1 and 3 months. The changes in negative area were significantly reduced after 1 month (p=0.041) and the ejection period was significantly increased at the 6 month follow-up (p=0.011). According to linear regression analysis systolic blood pressure correlated positively with the beta stiffness, pressure-strain elastic modulus, pulse wave velocity, and negatively with arterial compliance.
Conclusions: We found significantly lower office blood pressure as well as blood pressure from ambulatory blood pressure monitoring in patients with resistant hypertension 6 months after renal sympathetic denervation. The decrease in blood pressure was followed by improvement of carotid stiffness and wave intensity. That may be reflected in enhancement of ventricular-arterial coupling.